Published on 20. March 2018

Remote Relationship

Rainer W. suffers from chronic kidney failure. The Berlin retiree spends a large part of the year on Fuerteventura. During this time, he is treated via telemedicine - by a team of doctors at the Vivantes Friedrichshain Hospital.

The Canary Island of Fuerteventura is around 4,500 kilometers away from Berlin. Despite the great distance, 76-year-old Rainer W. is in daily contact with the dialysis team in Berlin-Mitte. This is made possible by a data transmission. Doctors are allowed to advise and treat patients remotely if they know them and have previously diagnosed their condition in person. This is the case of the retiree with his primary residence in Berlin-Charlottenburg. For the past year, his kidneys have been so badly damaged that they can no longer thoroughly clean the blood and eliminate toxins. The degradation products collect in the blood and damage the organism. Without regular dialysis, the patient, one of about 80,000 in Germany, would not be able to survive. He could also receive dialysis on Fuerteventura, but Prof. Dr. Martin Kuhlmann, head physician at the Clinic for Internal Medicine and Nephrology at the Vivantes Friedrichshain Hospital, explains: "Clinics and dialysis practices on Fuerteventura only perform hemodialysis. This form of 'blood washing' severely restricts the quality of life of patients, they have to pay particular attention to their diet and usually feel very exhausted after dialysis."
Another counter-argument is provided by the patient himself: "I would have to drive 40 kilometers to the nearest dialysis practice three times a week."

Dialysis by remote control

After extensive consultation with Prof. Martin Kuhlmann and his colleague Dr. Fabienne Aregger, Rainer W. therefore opted for peritoneal dialysis - a treatment alternative that had long been established in Germany but was not widely used. The patient received a dialysis machine (cycler) that can be controlled and monitored remotely. The necessary dialysis now takes place daily during the night. Rainer W. connects himself to the machine, connecting a tube to an access point on his abdomen. Dr. Fabiene Aregger explains the method: "The cycler pumps a sterile sugar-electrolyte solution into the abdomen and sucks it out again after a while. In several passes, water and toxins are thus removed from the body." The machine sends the data to Berlin in encrypted form via a modem,

Every morning, it is checked by the dialysis team at the Klinikum im Friedrichshain. Blood pressure and body weight are displayed and checked weekly. If necessary, the Vivantes experts react immediately and adapt the cycler's programming to new conditions; there is a 24-hour on-call service and a detailed emergency plan. Rainer W. feels fit, he is doing well. The telemedical treatment gives him independence and quality of life, and his health insurance company covers the costs.

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